Individual provider Active NPI

Karina Leiva Lopez

  • Endodontics
  • Plantation, FL
National Provider Identifier
1669997565
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DN22809 Issued in FL
Practice address
301 NW 84 Avenue, Ste 203
Plantation, FL 33324
Phone
(954) 947-1470
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN22809 FL
Endodontics 1223E0200X DN22809 FL Primary

Addresses

Primary practice location

301 NW 84 Avenue, Ste 203
Plantation, FL 33324

Mailing address

14444 Beach Blvd Ste 2
Jacksonville, FL 32250-2010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180510002571 FL Order and Referring Only - DentistPractitioner - Dentist 3678837044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN22809FLMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1669997565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14444 BEACH BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322502010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 NW 84 AVENUE, STE 203",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "33324",
            "telephone_number": "954-947-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIVA LOPEZ",
        "first_name": "KARINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN22809",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN22809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.